We report the sonographic features of an intracystic papillary carcinoma of the breast presenting as recurrent hemorrhagic cysts following trauma. A 56-year-old woman presented with palpable breast masses after a traumatic event; sonography showed multiple, well-defined, hemorrhagic cysts. Hemorrhagic fluid was evacuated by fine needle aspiration with no residual lesions. Cytology was negative for malignancy. Five months later, the mass reappeared; sonography demonstrated multiple cysts with solid nodules. US-guided core biopsy and surgery revealed invasive papillary carcinoma. We suggest close follow-up of cystic masses, even with negative cytology, and performance of surgical excisional biopsy in cases of rapid refilling after aspiration.
Ultrasonography, Mammary/methods ; Recurrence ; Middle Aged ; Mammography/methods ; Lymphatic Metastasis ; Humans ; Hemorrhage/*diagnosis/ultrasonography ; Female ; Diagnosis, Differential ; Cysts/*diagnosis/ultrasonography ; Carcinoma, Papillary/*diagnosis/ultrasonography ; Breast Neoplasms/*diagnosis/ultrasonography

PURPOSE: To evaluate the clinical usefulness of ultrasonography (US) - guided automated gun biopsy of nonpalpable breast lesions. MATERIALS AND METHODS: In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. RESULTS: In 29 of 30 lesions (96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows: one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibroadenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and inthese four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. CONCLUSION: US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US.
Biopsy* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Fibroadenoma ; Hemorrhage ; Hyperplasia ; Ultrasonography

Of all forms of ectopic gestation, the possibility of fertility catastrophe is highest with a cervical pregnancy. Though rare, it is a potentially life-threatening condition. In the past it was diagnosed late, after there was profuse hemorrhage from the cervix and it usually required hysterectomy. With ultrasound, diagnosis can be made earlier and conservative management attempted in order to preserve the reproductive potential. Methotrexate has been used both systemically and intra-amniotically to treat cervical ectopic gestation conservatively.
Cervix Uteri ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Hysterectomy ; Methotrexate ; Pregnancy* ; Ultrasonography

Simple liver cysts are common and benign lesions, and most of them are detected by ultrasonography (US) or computed tomography (CT) during a medical checkup. Because simple liver cysts are generally asymptomatic, they do not require treatment, although hemorrhage, infection or rupture may occur in rare cases and these cases must receive proper treatment. The diagnosis of simple liver cysts is usually easy because of their typical morphological findings on US or CT. However, when a liver cyst contains hemorrhage or it is inflamed on imaging studies, it is sometimes difficult to differentiate simple hepatic cysts from such conditions as cystadenoma and cystadenocarcinoma. In this report, we describe a case of simple liver cyst that was complicated by intracystic hemorrhage, and this malady was initially diagnosed as biliary cystadenocarcinoma. We successfully treated this lesion by left lateral segmentectomy.
Cystadenocarcinoma ; Cystadenoma ; Diagnosis ; Hemorrhage* ; Liver ; Mastectomy, Segmental ; Rupture ; Ultrasonography

The sonographic features of 23 lymphangiomas (19 pediatric patients) were compared with the pathologic findings. Nineteen lymphangiomas appesred as unicameral (n=2) and multiloculated (n=7) cystic masses. Remaining lesions were inhomogeneously echogenic mass with small cystic portions (n=3) and a mixed pattern (n=1). Fourteen of the multiloculated tumors had thin septa and 6 had solid echogenic foci. The fluid within the majority of the cyst was anechoic in 8 cases and echogenic in 11 cases. Correlation of the sonographic features with the pathologic findings demonstrated that the cystic spaces corresponded to the dilated lymphatic spaces lined with endothelium, separated by septa. Echogenic fluid represented hemorrhage. The echogenic component corres ponded to clusters of very smaller dilated lymphatic channels, thick fibro-fatty septa, or blood clot. The author's experience suggests that the most characteristic sonographic appearance of lymphangioma is a multiloculated cysti mass with thin septa, reflecting the preponderance of fluid-filled spaces. An atypical appearance usually reflects the presence of blood or dominancy of cavernous type. The information obtained with US imaging can help in providing a preoperative diagnosis and in planning surgical resection.
Child* ; Diagnosis ; Endothelium ; Hemorrhage ; Humans ; Lymphangioma* ; Ponds ; Ultrasonography*

Abdominal pregnancy is a rare form of ectopic pregnancy, which has been classified as early and advanced abdominal pregnancies. In case of early abdominal pregnancy, we may miss the diagnosis because the symptoms and clinical characteristics are non-specific. However, recently, the early diagnosis is made because of the development of quantitative beta-hCG measurement, transvaginal ultrasonography and the development of laparoscopy. Omental pregnancy is a very rare form of abdominal pregnancy, which is hard to detect early. When ruptured, it accompanies with massive hemorrhage. So, early diagnosis and treatment is essential to prevent high morbidity, mortality and serious complications. Definite diagnosis is made by cytopathologic examination of tissue specimen after surgery. We have experienced a case of ruptured early omental pregnancy and reviewed it briefly.
Diagnosis ; Early Diagnosis ; Female ; Hemorrhage ; Laparoscopy ; Mortality ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Ultrasonography

Uterine arteriovenous malformation(AVM) is a rare cause of massive uterine bleeding. Although uterine AVM is a rare cause of menorrhagia or postmenopausal bleeding, it is important to consider in the assessment of a patient with abnormal uterine bleeding because accurate diagnosis can allow appropriate treatment to be planned and avoid hysterectomy in women who wish to retain their reproductive capacity. Curettage may precipitate life-threatening hemorrhage and is therefore contraindicated when uterine AVM is suspected. These lesinons may be congenital or acquired. Acquired lesions are believed to follow trauma or may arise after choriocarcinoma or other gynecologic malignancies. Until rescently, this condition was difficult to diagnose and management almost always required hysterectomy. Doppler flow ultrasound and pelvic angiography are important for diagnosis and assessment. Transcatheter embolization has replaced hysterectomy as the treatment of choice in woman who wish to retain their fertility. We have experienced one case of uterine AVM complicated by partial hydatidiform mole, which is presented with a brief review of the literature.
Angiography ; Arteriovenous Malformations* ; Choriocarcinoma ; Curettage ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Hydatidiform Mole* ; Hysterectomy ; Menorrhagia ; Pregnancy ; Ultrasonography ; Uterine Hemorrhage ; Uterus*

Infantile hepatic hemangioma is benign vascular tumor and the most common liver tumor in infants. Small hepatic hemangioma is usually asymptomatic and seldom require therapy. Giant hepatic hemangioma, defined as more than 4 cm in diameter, is rare, but can lead to life-threatening complications such as consumptive coagulopathy, anemia, hemorrhage after tumor rupture and congestive heart failure due to arteriovenous shunting. Neonatal mortality rate is about 70-90%. The differential diagnosis of a fetal liver mass includes hemangioma, hepatoblastoma, and mesenchymal harmatoma. Although hepatic hemangioma represents the most common tumor of the liver in infant, the prenatal diagnosis of this condition has been rarely reported in the literature. we experienced a case of fetal hepatic hemangioma by prenatal sonography and report our case with a brief review of literature.
Anemia ; Diagnosis* ; Diagnosis, Differential ; Heart Failure ; Hemangioma* ; Hemorrhage ; Hepatoblastoma ; Humans ; Infant ; Infant Mortality ; Liver ; Prenatal Diagnosis ; Rupture ; Ultrasonography*

PURPOSE: This study aimed to determine the accuracy of ultrasonography (US) in detecting retinal detachment in vitreous hemorrhage (V-HEMO). METHODS: A chart review of 81 patients (86 eyes) who have undergone pars plana vitrectomy in the treatment of V-HEMO between June 1996 and June 2004 was done. RESULTS: The most common cause of vitreous hemorrhaging was proliferative diabetic retinopathy (PDR) (39 eyes, 45.3%), followed by ocular trauma (22 eyes, 25.6%). the correct anatomic position of the retina was identified with US in 72 of 86 eyes (83.7%), with eight false positives (9.3%) and six false negatives(7.9%). The sensitivity of US was calculated as 73% and specificity was 88%. US within the PDR group correctly identified 29 of 39 eyes (74.4%), and had a sensitivity of 62% and a specificity of 81%. US within the non-PDR group correctly identified 43 of 47 eyes (91.5%), and had a sensitivity of 89% and a specificity of 92%. CONCLUSIONS: It has been reported that US is an effective diagnostic tool in patients with media opacity, however physicians should bear in mind that US can be unreliable in some patients with PDR. Thus, caution is warranted in making diagnoses and determining the appropriated surgical procedure.
Diabetic Retinopathy ; Diagnosis ; Humans ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Sensitivity and Specificity ; Ultrasonography* ; Vitrectomy ; Vitreous Hemorrhage*

Intracystic papillary carcinoma (IPC) of the breast is very rare, and it has a much better prognosis than the other types of breast carcinoma. We experienced a case of intracystic papillary carcinoma that we diagnosed in an 83-year-old-woman. MR imaging of the IPC shows a multicystic appearance with a subacute or chronic stage of intracystic hemorrhage. The contrast-enhanced MR imaging demonstrates enhancement of the cyst wall and mural nodules, and this modality proved to be successful for making an accurate preoperative diagnosis.
Breast Neoplasms ; Breast* ; Carcinoma, Papillary* ; Diagnosis ; Hemorrhage* ; Magnetic Resonance Imaging ; Prognosis ; Ultrasonography*